建立真菌透甲模型及红色毛癣菌和短帚霉透甲时间的比较

目的通过建立真菌透甲模型,观察真菌透甲时间,来探讨红色毛癣菌与短帚霉的相互作用。方法建立真菌透甲模型,分为红色毛癣菌组、短帚霉组、短帚霉-红色毛癣菌混合组,分析各组透甲时间。结果透甲模型中,红色毛癣菌的透甲时间为（9.46±1.89）d,短帚霉的透甲时间为（2.62±0.96）d,混合组中短帚霉的透甲时间为（2.54±0.78）d。结论体外透甲模型中,短帚霉比红色毛癣菌先穿透甲板。混合组中,红色毛癣菌对短帚霉的透甲时间无明显影响。     

致病真菌对甲侵袭性的体外初步研究

目的观察不同致病真菌在体外对甲板的侵袭能力。方法将分离自甲真菌病患者的致病真菌包括白念珠菌、红色毛癣菌和短帚霉,接种到沙堡培养基中,同时将灭菌甲板埋植入接种处。第28d时,取出甲板,进行病理切片,观察真菌对甲板的侵袭能力。结果病理显示接种于红色毛癣菌及短帚霉的甲板内可见菌丝生长,而接种于白念珠菌的甲板内无菌丝生长。结论皮肤癣菌和霉菌可以在甲板内侵袭生长,而白念珠菌对甲板无侵袭能力。     

5％阿莫罗芬甲涂剂治疗兔甲真菌病的疗效观察

目的 建立甲真菌病动物模型,观察局部使用5％阿莫罗芬甲涂剂治疗模型甲的疗效.方法 我们将须癣毛癣菌接种在新西兰白兔的后肢趾甲上,构建兔甲真菌病模型,感染成功后予组织病理学检查观察真菌在甲内的生长形态和方式,并外用5％阿莫罗芬甲涂剂治疗模型甲4周,用真菌学半定量培养评估其疗效.结果 在免疫抑制的情况下,须癣毛癣菌感染新西兰白兔的甲真菌病模型构建成功,接种1周后趾甲近端即出现白色、淡黄色云雾状的改变,与人甲真菌病的临床改变相似.组织学可以看到有隔分支菌丝穿入甲板,到达甲床.接种后2、4、6周,模型甲总体感染率分别为52.78％、77.78％和83.33％.外用5％阿莫罗芬甲涂剂治疗2、4周时真菌学有效率分别是22.22％和66.67％.结论 成功建立了甲真菌病的动物模型,并用此模型评估了外用抗真菌药的疗效,5％阿莫罗芬甲涂剂治疗兔甲真菌病4周的真菌学有效率为66.67％.     

7种甲真菌病致病菌的侵袭力比较

目的观察红色毛癣菌、白念珠菌、红酵母、短帚霉、串珠镰刀菌、烟曲霉、绳状青霉是否具有侵犯离体甲板的能力,并比较其侵袭能力的强弱。方法将无菌甲板接种于红色毛癣菌、白念珠菌、红酵母、短帚霉、串珠镰刀菌、烟曲霉、绳状青霉7种真菌的3种不同培养基(固体沙氏培养皿、液体沙氏试管及生理盐水试管)中,定期用NaOH溶甲法分析甲板受侵程度。结果某些非皮肤癣菌性丝状真菌侵犯体外甲板的能力与红色毛癣菌基本相同,但丝状真菌比酵母菌强,酵母菌中白念珠菌比红酵母强。同一种真菌在固体培养基上对甲板的侵袭力远比在液体培养基中或生理盐水中强。结论一定条件下,某些非皮肤癣菌也能直接侵犯甲板。真菌侵犯甲的能力与其形成菌丝的能力及其与甲板接触的稳定性成正比。     

甲癣的病原学研究进展

甲真菌病是由皮肤癣菌、酵母菌及霉菌引起的甲板和甲下组织感染,皮肤癣菌是主要致病菌,其所致的甲真菌病称为甲癣.皮肤癣菌分为3个属:毛癣菌属、小孢子菌属和表皮癣菌属.随着医学真菌学基础知识的普及和真菌学诊疗水平的提高,越来越多的皮肤癣菌在甲中分离,临床上对甲癣致病真菌的正确鉴定对于制定治疗方案、评价预后以及流行病学监测等都有重要的指导意义.该文对国内外现有文献报道的甲癣的致病菌进行综述.     

甲真菌病的中西医治疗进展

<正>1甲真菌病的病因引起甲真菌病的真菌多为皮肤癣菌、霉菌及酵母菌等。由皮肤癣菌引起的甲真菌病又称为甲癣。皮肤癣菌主要分为毛癣菌属和小孢子菌属和表皮癣菌属,以毛癣菌属最常见^[1]。2甲真菌病的中医认识2.1 病因病机中医称之为“灰指/趾甲”,认为“肝其华在爪”,甲之华乃肝之气所生,甲之病与肝密切相关,但对其病因病机各家认识不一。单敏洁等^[2]认为此病是虫淫侵蚀肌肤、甲板所致;杨文喜^[3]认为本病发病责之脾肾阳虚,腠理不密,     

红色毛癣菌和枝孢样枝孢霉混合感染导致银屑病患者甲真菌病1例

目的报道1例银屑病患者出现红色毛癣菌和枝孢样枝孢霉混合感染导致的甲真菌病。方法报告病例,对甲标本进行真菌镜检和培养,对病原菌进行形态学及分子生物学鉴定。结果该病例经临床、真菌镜检和真菌培养鉴定,确诊为红色毛癣菌和枝孢样枝孢霉导致的甲真菌病。病原菌通过菌落和显微镜下形态特征结合rRNA内转录间隔区序列分析证实。结论通过形态学及分子生物学鉴定,证实为真菌红色毛癣菌和枝孢样枝孢霉混合感染导致的甲真菌病。     

短波紫外线对几种常见浅部真菌生长的影响

目的 了解短波紫外线对几种常见浅部真菌生长的影响.方法 将红色毛癣菌、须癣毛癣菌、犬小孢子菌、絮状表皮癣菌、白念珠菌、光滑念珠菌、近平滑念珠菌、热带念珠菌、克柔念珠菌、青霉、短帚霉、枝顶孢霉接种在沙氏培养基上,按不同照射功率、不同照射距离和不同照射时间分组用紫外线灯进行照射,观察记录照射后菌落的生长情况,并在透射电镜下观察菌丝或孢子的形态结构变化.结果 犬小孢子菌、絮状表皮癣菌、白念珠菌、近平滑念珠菌、克柔念珠菌经照射后停止生长;红色毛癣菌、须癣毛癣菌、光滑念珠菌、热带念珠菌、短帚霉和枝顶孢霉在某些照射条件下可以继续生长,但生长速度减缓.结论 短波紫外线对常见浅部真菌有不同程度的杀灭和抑制作用,该作用的大小与紫外线照射强度和照射时间成正比,与照射距离成反比.     

红色毛癣菌菌株的特异性PCR鉴定方法研究

目的建立一种快速的红色毛癣菌分子生物学鉴定方法。方法根据红色毛癣菌保守区域-真菌核糖体DNA（rDNA）的转录间隔区（ITS）设计特异性引物,采用上游：ITS19865＇GAC ACC AAG AAA AAA TTC TCT GAA GA3＇,下游：ITS24415＇GTC CTG AGG GCG CTG AA3＇为引物对45株红色毛癣菌、5株须癣毛癣菌和1株紫色毛癣菌菌株的DNA进行PCR扩增,观察产物电泳带型的差异。结果 45株红色毛癣菌均能扩增出目的片段,5株须癣毛癣菌和1株紫色毛癣菌均无目的片段扩增出。结论红色毛癣菌可用特异引物PCR方法快速鉴定。     

芫花花蕾中一个新的瑞香烷二萜类化合物CSCD

为了研究中药芫花(Daphne genkwa)的干燥花蕾化学成分及其抑制皮肤病原真菌活性,采用正相硅胶及半制备HPLC等多种色谱技术对芫花花蕾95%乙醇提取物进行分离纯化得到2个瑞香烷型二萜类化合物,并通过MS、NMR和ECD等波谱技术和文献数据比对鉴定化合物结构,分别为daphgenin A(1)和yuanhuakine B(2),其中化合物1为新的瑞香烷型二萜类化合物。同时,结合MIC法测定该化合物对皮肤真菌犬小孢子菌、红色毛癣菌、须癣毛癣菌和马拉色菌的抑制活性,结果表明化合物1和2对皮肤病原真菌有一定的抑制活性,化合物1对红色毛癣菌和须癣毛癣菌的抑制活性与阳性对照组相当(MIC值4.0μg/mL),化合物2对红色毛癣菌显示显著的抑制活性,其MIC值为2.0μg/mL。     

Toenail Onychomycosis in a Portuguese Geriatric Population

Onychomycosis is a common fungal infection of the nail but few data of mycological features in geriatric Portuguese population are yet available. The aim of this study was to perform a mycological examination and characterization of fungal nail pattern of a geriatric population from the north of Portugal clinically suspected of onychomycosis. A total of 108 patients attending the Podology Service in the Centro Hospitalar do Alto Ave (Portugal) from October 2007 to January 2009 were enrolled. All were suspected of having onychomycosis by the abnormal appearance of their nails. From these, 59.3% were diabetic. Distal and lateral subungual onychomycosis was the more common clinical pattern followed by total dystrophic onychomycosis. In 21.3% cases, every nail in both feet had an abnormal appearance. In 86%, the hallux was involved in at least one foot. Fifty samples were culture positive, and fifty-four isolates were reported regardless of the questionable pathogenicity of the infectious agent. In three cases, clinical feature of the nail, direct microscopy, and culture were consistent with Scopulariopsis infection. Fusarium spp. were identified in three cases; however, only one isolate was preceded by the observation of branching septate filaments by direct microscopy. No mixed infections with dermatophytes were reported. Trichophyton rubrum was the dermatophyte most frequently isolated (83.3%) followed by Trichophyton interdigitale. In Portugal, onychomycosis is still viewed by general population as a cosmetic condition. Health risk is enhanced in geriatrics that only perceived the severity of their condition when experiencing further foot complications that include bacterial infection and pain.     

Epidemiology of superficial mycosis (tinea pedis, onychomycosis) in elementary school children in Istanbul, Turkey

The purpose of this study is to determine the prevalence of tinea pedis and onychomycosis in children of elementary school age and to examine the socio-demographic attributes that may be effective in correlation of both mycoses. 3,390 female and 3,768 male children between ages 6-14 have been examined in seven schools. Skin scrapings and nail samples were taken from 13 students who were suspected to have tinea pedis and from 49 students who were suspected to have onychomycosis. According to direct microscopy (10-15% KOH+calcofluor white) and culturel examination (Sabouraud dextrose agar and dermatophyte test medium) 11 students were diagnosed as tinea pedis and 24 were diagnosed as onychomycosis. Trichophyton rubrum was isolated in 3 students with tinea pedis whose culture was positive and five Candida albicans, five Candida glabrata and one Candida tropicalis cases were isolated from 11 samples with onychomycosis. Tinea pedis prevalence has been found to be 3.3%0. Differences between onychomycosis prevalence based on age have been found to be significant (p < 0.001). In conclusion, it has been determined that the prevalence of tinea pedis and onychomycosis among children is low. Candida spp. was isolated from all of the 14 samples diagnosed as onychomycosis. Our study shows similar results with previous studies done in Turkey and that Trichophyton rubrum continues to be the most isolated agent.     

Onychomycosis in Malaysia

The common etiological agents of onychomycosis are dermatophytes, molds and yeasts. A mycological nail investigation of onychomycosis using direct microscopy and culture was conducted by the Mycology Unit, Department of Medical Microbiology, University of Malaya from March 1996 to November 1998. The study involved 878 nail clippings or subungal scrapings from subjects with onychomycosis. On direct microcopy examination, 50% of the specimens were negative for fungal elements. On culture, 373 specimens had no growth; bacteria were isolated from 15 nail specimens. Among the 490 specimens with positive fungal cultures, 177 (36.1%) were dermatophytes, 173 (35.5%) were molds and 130 (26.5%) were Candida. There were 2% (10/490) mixed infections of molds, yeasts and dermatophytes. Trichophyton rubrum (115/177) and Trichophyton mentagrophytes (59/177) were the main dermatophytes isolated. The molds isolated were predominantly Aspergillus niger (61/173), Aspergillus nidulans (30/173), Hendersonula toruloidea (26/173) and Fusarium species (16/173). 96.9% of the Candida species identified were Candida albicans.This revised version was published online in October 2005 with corrections to the Cover Date.     

Onychomycosis and <Emphasis Type="Italic">Tinea Pedis</Emphasis> in Athletes from the State of Rio Grande Do Sul (Brazil): A Cross-Sectional Study

Onychomycosis and tinea pedis are common superficial infections caused primarily by dermatophytes. The aim of this investigation was to study the epidemiology, etiological agents, and potential risk factors for infection based on comparison of athletes and non-athletes from a northern region of Rio Grande do Sul (Brazil). Each group consisted of 100 male individuals with ages ranging from 18 to 40 years. After a clinical examination, samples were taken from individuals presenting signs of onychomycosis and/or tinea pedis for direct microscopic examination and culture. Among the athletes, the frequency of onychomycosis and/or tinea pedis was 32%, and for the control group, it was 20%. The athletes presented 16% of onychomycosis, 12% of tinea pedis, and 4% of onychomycosis and tinea pedis together. The distribution in the control group was 10% of onychomycosis, 7% of tinea pedis, and 3% of this association. The pathogens identified were dermatophytes (84.8%) and yeasts (15.2%), and the most commonly identified organism was Trichophyton rubrum, followed by Trichophyton mentagrophytes var. interdigitale. No significant differences were found when the frequency of species distribution in the athletes and non-athlete groups was compared. Risk factors for onychomycosis in athletes included familial cases of fungal infection, contact with domestic animals, and nail trauma, while the risk factors in non-athletes included the habit of not using sandals in public bathrooms and nail trauma. For tinea pedis, the habit of not using sandals in public bathrooms was a predisposing factor in both groups, while hyperhydrosis was a risk factor only in non-athletes. This study concludes that despite the higher number of fungal infections in athletes, there is no significant difference between these groups.     

First Case of Tritirachium oryzae as Agent of Onychomycosis and Its Susceptibility to Antifungal Drugs

The first case of Tritirachium oryzae isolated from an Iranian patient is reported. A 44-year-old woman with a lesion in her fingernail was examined for onychomycosis. Direct microscopic examination of the nail clippings revealed fungal filaments and inoculation of portions of the nail clippings on cultures media yielded T. oryzae after 8 days. The isolate was identified as Tritirachium spp. on the basis of gross morphological characteristics of the fungal colony and microscopic characterization of slide cultures. The diagnosis of T. oryzae was confirmed by PCR sequencing of the internal transcribed spacer domain of the rDNA gene. In vitro antifungal susceptibility test demonstrated that the fungus was susceptible to itraconazole and posaconazole. The patient was treated with oral itraconazole.     

Influence of a Combination of Chemical Enhancers and Iontophoresis on <Emphasis Type="Italic">In Vitro</Emphasis> Transungual Permeation of Nystatin

To promote transungual permeation of nystatin (NYST), molecule with high molecular weight, no water-soluble, amphoteric by iontophoresis. The synergic effect of the combination of cetylpyridinium chloride, CPC, or polyoxyethylene (20) sorbitan monooleate, TW80, and iontophoresis was investigated. In vitro permeation experiments were carried out through bovine hoof slices using vertical diffusion cells. A low current density (0.2 mA/cm²) was applied by introducing Ag/AgCl electrodes in the donor (anode) and receptor (cathode) chambers. The donor phase consisted of a solution, a suspension, or gel-type vehicles containing NYST and surfactants in pH 5.6 HEPES buffer. The addition of CPC to NYST suspension (SOSP) produced a fivefold increase on the permeability of the bovine hoof membrane to the drug. The application of anodal iontophoresis further improved NYST flux. Conversely, NYST transungual permeation was not influenced by TW80 either in the passive diffusion or iontophoretic flux. Furthermore, the iontophoretic treatment does not appear to induce irreversible alterations to the hoof bovine membranes. The present work demonstrated the efficacy of iontophoresis as a treatment for different nail pathologies with large molecules very slightly soluble in water without irreversibly affecting the nail structure. A synergistic effect between CPC and iontophoresis was observed.     

Medically important fungi found in hallux nails of university students from Cali, Colombia

The presence of medically important fungi was studied in hallux nails scrapings obtained from 504 students (204 males, 300 females) of three universities in Cali. Specimens were examined by direct microscopic examination and fungal culture. Medically important fungi were found in 49 (9.7%) students, 24 (4.8%) had onychomycosis while the rest did not have nail lesions. Trichophyton rubrum was the most commonly isolated fungi in students with lesions, where as T. mentagrophytes predominated in healthy nails. Most of the students with fungi were males. The prevalence of fungi was higher in individuals between 26 and 35 years. No association was observed between fungi and practicing sports or undergoing pedicures. These results suggest that dermatophytes can be found in healthy hallux nails, which can be reservoirs of pathogenic fungi.